Mediating role of anxiety between body image distress and quality of life among women with polycystic ovary syndrome: a multicentre cross-sectional study

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Body image distress (BID) refers to psychological distress caused by deviations in the individual’s self-aesthetic ability. The objectives of this study are to investigate the prevalence of psychological distress; and to assess the role of anxiety in the relationship between body image distress and quality of life (QoL) among women with polycystic ovary syndrome using a path analysis approach.

A multi-center cross-sectional study design was conducted among 294 women with PCOS in 29 provinces in mainland China from July 2021 to December 2021, and the data were analyzed using path analysis. The Multidimensional Body-Self Relations Questionnaire-Appearance Scales, Modified Polycystic Ovary Syndrome Questionnaire, and Hospital Anxiety and Depression Scale were administered to women who gave informed consent to participate.

The results of path analysis are indicated that anxiety significantly mediated BID and QoL in women with PCOS (p < 0.05) and the structural equation model analysis further confirmed the statistical significance of this mediating effect. The fit indices CFI = 1.00, TLI = 1.00, and RMSEA = 0.00, indicating that the model represents the data well. A good fit of the proposed model to the observed data was obtained, which revealed that BID not only directly influenced QoL, but also had a significant indirect effect on QoL via anxiety.

Psychological counseling clinics is as well needed to provide patients with individualized psychological counseling and avoid mental health problems caused by body image troubles. Anxiety mediated the relationship between BID and QoL, adding to the paucity of research for women with polycystic ovary syndrome.